Medial Epicondylitis

Definition

Medial epicondylitis is pain over the bone on the inner side of the elbow. The piece of bone that can be felt on the inner side of the elbow is called the medial epicondyle. When the tendons attached to this bone are overstretched or torn, they can become painful. This is called
tendinopathy
.

Medial epicondylitis is commonly called golfer's elbow, but it is not restricted to people who play golf. It can occur in tennis players and other people who repeatedly grip objects tightly.

Causes

Golfer's elbow is caused by overusing the flexor muscles of the forearms. Overusing these muscles can stretch or tear the tendons attached to the medial epicondyle.

Causes include:

Improper golf swing technique or grip of golf clubs

Wrong model of golf clubs

Improper technique for hitting a tennis ball

Improper size of tennis racquet or tension of racquet strings

Doing certain arm motions too much, such as:

Golf swings

Tennis strokes (forehand or serve)

Painting

Raking

Pitching

Rowing

Using a hammer or screwdriver

Risk Factors

Factors that may increase your chance of medial epicondylitis include:

Playing golf or tennis

Work that requires repetitive gripping or clenching of the fingers (especially when the hand is bent up or down at the wrist)

Muscle imbalance

Decreased flexibility

Advancing age

Symptoms

Symptoms include:

Pain or tenderness on the inner side of the elbow

Pain increases when:

Shaking hands

Turning doorknobs

Picking up objects with your palm down

Hitting a forehand in tennis

Swinging a golf club

Applying pressure to this area

Possibly pain extending down the forearm

Tightness of forearm muscles

Stiffness or trouble moving the elbow or hand

Diagnosis

The doctor will ask about your symptoms, medical history, recent physical activity, and how the injury occurred. You may not remember the event that caused the injury because golfer's elbow pain develops over time. The doctor will examine your elbow for:

Pain on the inner side of the elbow when:

Doing certain arm motions

Pressing on the medial epicondyle

Stiffness of elbow and pain with wrist movement

X-rays
are not usually necessary. However, an x-ray may be needed if the doctor suspects other problems.

An
MRI scan
is occasionally used for diagnosis, but there is only limited evidence supporting this use.

Treatment

Treatment includes:

Rest

Do not do activities that cause pain. Do not play sports, especially golf and tennis, until the pain is gone. You may need to alter how you do certain activities.

Cold

Regular ice application may help decrease some discomfort and swelling.

Medication

The following drugs can help to reduce inflammation and pain:

Nonsteroid anti-inflammatory drugs (NSAIDs)

Acetaminophen

Topical pain relievers that are applied to the skin

If you still have tenderness in the elbow while taking these drugs, do not return to physical activity. Check with your doctor.

Compression

Wear a counter-force brace on your forearm if recommended by your healthcare professional. This brace limits the force generated by your forearm muscles when you use them.

Heat

Apply heat to the elbow only when you are returning to physical activity. Then use it before stretching or getting ready to play sports.

Stretching

When the acute pain is gone, start gentle stretching as recommended by a healthcare professional. Stay within pain limits. Hold each stretch for about 10 seconds and repeat 6 times.

Strengthening

Begin strengthening exercises for the flexor muscles of the forearm as recommended.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.